Predictive Value of the Endometriosis Fertility Index for Post-Surgical Conception: A Single-Center Experience from Yaounde, Cameroon

What is known. The endometriosis fertility index (EFI) predicts spontaneous pregnancy after endometriosis surgery. It integrates historical factors (age, infertility duration) and surgical findings (disease severity, pelvic function). The problem addressed. The EFI's validity is unproven in Central Africa, where diagnostic delay leads to advanced endometriosis. It is unclear which index components retain predictive power in this high-severity context. What this study adds to our knowledge. This first Central African evaluation of 30 women found a 23.3% post-surgical conception rate. Despite 53.5% having severe disease, the EFI significantly predicted conception (p=0.004). Crucially, the surgical Least Function Score was the sole independent predictor (HR=0.540, p=0.035), whereas patient age and infertility history were not. How this is relevant to clinical practice or further research. The results validate the EFI's use in this setting. They shift clinical focus toward optimizing surgical quality to maximize pelvic anatomical function, as this outweighs the negative prognosis of long-standing infertility. This supports targeted investment in advanced laparoscopic training to improve fertility outcomes. This publication is available in full in Health Sciences and Disease.